Literature Evaluation Table Paper
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Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article
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Article Title and Year Published
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Research Questions/ Hypothesis, and Purpose/Aim of Study
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Design (Quantitative, Qualitative, or other)
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Setting/Sample  Struggling to meet your deadline ?Get assistance on Literature Evaluation Table Paper done on time by medical experts. Don’t wait – ORDER NOW!
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Methods: Intervention/ Instruments
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Analysis/Data Collection
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Outcomes/Key Findings
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Recommendations
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Explanation of How the Article Supports Your Proposed EBP Practice Project Proposal |
| Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C. (2019). Assessing the effectiveness of engaging patients and their families in the three-step fall prevention process across modalities of an evidence-based fall prevention toolkit: an implementation science study. Journal of medical internet research, 21(1), e10008. doi:10.2196/10008 | Assessing the Effectiveness of Engaging Patients and Their Families in the Three-Step Fall Prevention Process Across Modalities of an Evidence-Based Fall Prevention Toolkit: An Implementation Science Study, 2019
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Hypothesis: The relative effectiveness of the Patient-Centered Fall Prevention Toolkit, Fall TIPS (Tailoring Interventions for Patient Safety) is still unknown.
Purpose: To determine whether the Fall TIPS modality affects patient engagement in the stepwise fall prevention process (3-steps)and thus Fall TIPS efficacy. |
Qualitative study | The study was conducted at Brigham and Women’s Hospital (Boston, MA, USA), NewYork-Presbyterian Hospital, and Montefiore Medical Center (MMC; Bronx, NY, USA). | The effectiveness of three bedside modalities such as the electronic Fall TIPS poster, laminated Fall TIPS poster, and the paperless patient safety bedside display, were determined. | Random audits were carried out with questions to collect information regarding the effectiveness of the 3 bedside modalities in reducing the rates of falls in hospitals. | Each of the 3 Fall Tips modalities was effective in facilitating the engagement of patients in the stepwise fall prevention process (3 steps) leading to a reduced rate of falls among hospitalized patients. | Healthcare organizations must consider the adoption of fall prevention modalities that suits their culture and health information technology infrastructure for great effectiveness. | From this study, it is clear that any form of fall prevention modality which is suitable for your organization like the Fall TIPS Toolkit can significantly reduce the rates of falls among hospitalized patients if implemented appropriately. |
| Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons, and alarms. BMJ Open Quality, 6(2), e000119. https://doi.org/10.1136/bmjoq-2017-000119 | Reducing medical-surgical inpatient falls and injuries with videos, icons, and alarms, 2017.
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Hypothesis: Fall prevention visual signaling icons and patient education videos are effective in reducing fall incidences in the medical and surgical wards when used together.
Purpose: To determine the effectiveness of fall prevention visual signaling icons and patient education videos when utilized together with bed exit alarms in reducing the incidences of falls and injury among acutely hospitalized medical-surgical patients. |
Performance improvement study with historic control | Four medical-surgical units were selected in an urban public safety net teaching hospital in the United States. | Patients were shown a 4-minute video filmed in a patient’s room suggesting the way they can reduce the risks of falls. | A narrative description of incidences of falls was reported electronically based on the measurement outcomes to the hospital’s unusual occurrence database. | The incidences of falls and associated injuries reduced significantly with patient education and continued use of bed exit alarms. | Future studies should focus on evaluating the effectiveness of fall prevention programs that mainly control known risk modifiers like patient age and gender, admitting diagnosis, and length of stay in addition to nurse staffing. | This study provides evidence that there is still a need for the development and implementation of appropriate fall prevention interventions like the Fall TIPS Toolkit. |
| Tzeng, H. M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C. (2021). Adopting the fall Tailoring Interventions for Patient Safety (TIPS) program to engage older adults in fall prevention in a nursing home. Journal of nursing care quality, 36(4), 327-332. DOI: 10.1097/NCQ.0000000000000547
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Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home, 2021
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Hypothesis: The Fall Tailoring Interventions for Patient Safety (TIPS) program on fall prevention are effective in reducing the number of falls, and related injuries among hospitalized patients.
Purpose: To determine the significance of the Fall Tailoring Interventions for Patient Safety (TIPS) program on falls prevention among the elderly in the subacute care unit. |
Quality Improvement study | The study was carried out in a 15-bed subacute care unit in Canada within a government-funded nursing home. | The intervention being tested in this study is the Fall TIPS program adopted in a nursing home for the elderly. | The Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines were utilized to report the collected data. | The rates of falls and associated injuries decreased significantly with the implementation of the Fall TIPS intervention. | It is crucial to engage nursing home elderly residents in fall prevention intervention to promote the incorporation of patient-centered interventions into clinical practice. | Despite the study being conducted in a nursing home, the effectiveness of the Fall TIPS program displayed will still show the same level of effectiveness even in hospitalized patients in the medical-surgical unit. |
| Avanecean, D., Calliste, D., Contreras, T., Lim, Y., & Fitzpatrick, A. (2017). Effectiveness of patient-centred interventions on falls in the acute care setting compared to usual care. JBI Database of Systematic Reviews and Implementation Reports, 15(12), 3006–3048. https://doi.org/10.11124/jbisrir-2016-003331 | Effectiveness of patient-centered interventions on falls in the acute care setting compared to usual care: a systematic review, 2017
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Hypothesis: Patient-centered fall interventions are effective in reducing the rate of falls among hospitalized patients.
Purpose: To determine the effectiveness of patient-centered fall prevention interventions in an acute care setting. |
Quantitative Study | Hospitalized adult patients in the medical or surgical acute care units were utilized in this study. | Comprehensive literature review on patient-centered intervention strategies in reducing hospital falls in comparison with usual care. | Qualitative and qualitative data were extracted from articles selected from database searches including Embase, CINAHL, and PubMed. The review was then presented in narrative form. | Patient-centered interventions together with tailored patient education are associated with a significant reduction in fall incidences in acute care hospitals. | Due to the limited evidence supporting patient-centered fall prevention intervention, there is a need for the researchers to work on the same to promote more evidence allowing use in clinical practice. | The study outcome provides evidence supporting the effectiveness of patient-centered interventions together with tailored patient education in reducing the rate of falls. These interventions are similar to Fall Tailored Interventions for Patient Safety (TIPS) Toolkit. |
| Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., Ergai, A., Lindros, M. E., Lipsitz, S. R., Scanlan, M., Shaykevich, S., & Bates, D. W. (2020). Evaluation of a Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries. JAMA Network Open, 3(11), e2025889. https://doi.org/10.1001/jamanetworkopen.2020.25889 | Evaluation of a Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries, 2020
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Hypothesis: A fall prevention tool kit that considers engaging patients and their family members is associated with a reduction in the rate of falls.
Purpose: To evaluate the effectiveness of the fall prevention toolkit which engages patients together with their family members in the reduction of falls and associated injuries among hospitalized patients. |
Nonrandomized Controlled Trial | The study was carried out in 14 medical units in three academic medical centers in New York and Boston. | Interventions: A nurse-led fall prevention toolkit that links patient-specific fall risk factors and appropriate evidence-based prevention intervention, designed to continuously engage patients and their family members in the fall prevention process. | The collected feedback from patients by unit base nurse champion was analyzed using SAS statistical software, version 9.4 (SAS Institute) | The implementation of the fall prevention tool kit led to a 15% reduction in inpatient falls, and a 35% decrease in injury falls. | Fall prevention tool kit should be incorporated into clinical guidelines to promote its use in practice given the amount of evidence supporting its effectiveness. | The study results support the intervention on the use of the Fall tips toolkit in reducing rates of falls among hospitalized patients, as described in my project. |
| Dykes, P. C., Duckworth, M., Cunningham, S., Dubois, S., Driscoll, M., Feliciano, Z., … & Scanlan, M. (2017). Pilot testing fall TIPS (tailoring interventions for patient safety): a patient-centered fall prevention toolkit. The Joint Commission Journal on Quality and Patient Safety, 43(8), 403-413. DOI: 10.1016/j.jcjq.2017.05.002
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Pilot Testing Fall TIPS (Tailoring Interventions for Patient Safety): A Patient-Centered Fall Prevention Toolkit, 2017 | Hypothesis: Fall TIPS Toolkit (Fall TIPS) should be laminated and placed at the bedside of each patient providing a link between patient fall risk assessment and appropriate evidence-based intervention to reduce the number of falls in hospitals.
Purpose: To determine the effectiveness of Fall TIPS in reducing rates of falls among hospitalized patients. |
Pilot study | The study was conducted at Montefiore Medical Center (MMC; Bronx, New York), and Brigham and Women’s Hospital (BWH; Boston). | Pilot implementation of Fall TIPS in the selected hospitals by utilizing the conceptual model. | Auditing was conducted to assess and provide feedback on the adherence to the outlined fall prevention protocol and patient outcome. | The average compliance rate with the use of Fall TIPS was approximately 82% with a reduction in the rates of fall by 3.28 to 2.80 falls per 1,000 patient days. | Hospitals and clinical leadership should be engaged in the translation of evidence-based care such as the implementation of Fall TIPS into clinical practice. | The study provided evidence supporting the effectiveness of the Fall TIPS tool kit in reducing the number of falls and injuries among hospitalized patients, with great adherence from both the patients and clinicians. |
| Johnston, M., & Magnan, M. A. (2019). Using a Fall Prevention Checklist to Reduce Hospital Falls. AJN, American Journal of Nursing, 119(3), 43–49. https://doi.org/10.1097/01.naj.0000554037.76120.6a
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Using a Fall Prevention Checklist to Reduce Hospital Falls: Results of a Quality Improvement Project, 2019 | Hypothesis: Improving clinician adherence to an existing hospital-approved fall prevention protocol is associated with improved patient safety.
Purpose: To determine the impact of utilizing a fall prevention checklist on the implementation of a 14 specific intervention bundle (the fall prevention protocol) and the fall incidences in the participating units. |
Pilot Study | A total of 37 nursing staff members, both RNs and nursing assistants took part in this pilot study. | The quality improvement team carried out a 26-day full prevention initiative to evaluate the impact of utilizing a new checklist with 14-items based on the current hospital-approved protocols for fall prevention and nursing staff’s adherence. | The process of data collection was done on day and night shifts for
days each for the period before and after implementation of the 14 item checklist. |
No patient falls were reported during the pilot study. However, the most frequently missed intervention upon implementation of the fall prevention checklists was setting bed alarms. | There is a need for a more comprehensive test of the impact of the fall prevention checklists on fall prevention. | The study, confirm the need to improve adherence by healthcare providers and patient in the use of fall prevention interventions at all times in the hospital to reduce the number of falls. |
| Jong, L. D., Weselman, T., Kitchen, S., & Hill, A. (2019). Exploring hospital patient sitters’ fall prevention task readiness: A cross‐sectional survey. Journal of Evaluation in Clinical Practice, 26(1), 42–49. https://doi.org/10.1111/jep.13114
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Exploring hospital patient sitters’ fall prevention task readiness: A cross-sectional survey, 2019
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Hypothesis: Patient sitters help in preventing falls among patients at risk by providing one on one care to the hospitalized patient.
Purpose: To explore the patient sitters’ task readiness to help with the prevention of hospital falls in the medical and surgical ward. |
Cross-sectional survey | The study was conducted among patient sitters who were working in the selected hospitals in different shifts between June 2017 and June 2018. | A cross-sectional survey was conducted in five hospitals that were providing surgical, medical, and aged care to evaluate the impact of patient sitters on fall prevention. | Data was collected by allowing patient sitters to respond to open-ended items regarding factors that lead to falls, barriers, and enablers to fall prevention. The survey utilized categorical, multiple-choice, and open-ended responses. | The study participants identified patient factors like confusion as to the main cause of falls. Aggressive patient behavior was reported as the main barrier to the implementation of all prevention interventions. Patient sitters were however motivated to prevent their patients from falling. | Hospitals should focus on promoting cooperation and communication between nursing staff and patient sitters for better implementation of fall prevention strategies. | The study reveals the need to incorporate patient sitters in promoting fall prevention strategies among their patients. This is one of the strategies outlined in the Fall TIPS Toolkit, which is the focus of my project. |
| Radecki, B., Reynolds, S., & Kara, A. (2018). Inpatient fall prevention from the patient’s perspective: a qualitative study. Applied Nursing Research, 43, 114-119. https://doi.org/10.1016/j.apnr.2018.08.001 | Inpatient fall prevention from the patient’s perspective: A qualitative study, 2018.
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Hypothesis: Patient perspectives of falls play a significant role in the development of appropriate fall strategies in acute care settings.
Purpose: To determine how the patient’s perspective of fall prevention helps in designing patient-centered fall preventions strategies in acute care settings. |
Qualitative Study | The study was carried out in an academic healthcare center in the United States using hospitalized patients as participants. | The study evaluates the perspective of patients on fall prevention interventions like fall alarms. | Semi-structured interviews were utilized to collect data from the sample population on their perspective on fall prevention strategies. | The researchers found out that most of the fall prevention interventions favor clinician-led plan development and implementation. | Hospitals must ensure that patient fall assessment shifts from clinician-centered to patient-centered to promote great effectiveness in reducing falls by the patients and nurses, rather than nurses alone. | The study reports on the need for promoting patient center fall prevention interventions like the Fall TIPS Toolkit, as a result of great effectiveness over clinician-led interventions. |
| Mayhob, M. M., & Amin, M. A. (2022). Fall Prevention Interventions: Tailored Approach versus Routine Interventions among Elderly Hospitalized Patients. American Journal of Nursing Research, 10(1), 26-33. DOI:10.12691/ajnr-10-1-4
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Fall Prevention Interventions: Tailored Approach versus Routine Interventions among Elderly Hospitalized Patients, 2022 |
Hypothesis: Tailored Intervention Patient Safety (TIPS) is effective in preventing falls among hospitalized patients as compared to routine interventions. Purpose: To compare the impact of a tailored approach over routine intervention in the prevention of falls among hospitalized patients. |
A quasi-experimental design | The study was conducted in a medical ward in a government hospital, with hospitalized elderly patients as the sample population. | A quasi-experimental design was utilized to assess the impact of tailored intervention over the routine practice in fall prevention among elderly hospitalized patients. | Two tools were used to collect data, with the first tool having two parts as assessment of patient’s demographic data and the Morse Risk Assessment Scale for fall. The second tool was utilized in assessing implementing TIPS tailored approach in reducing fall incidences. | The study outcome revealed that patients who were subjected to routine fall interventions had 1.3 times the risks of falls as compared to those who received tailored interventions. | More studies need to be conducted to come up with and incorporate TIPS tailored approaches for fall prevention, to replace routine fall prevention interventions in hospitals. | The stud supports the use of tailored approaches over the routine practice in fall prevention, with evidence showing great effectiveness of the Fall TIPS Toolkit. |
References
Avanecean, D., Calliste, D., Contreras, T., Lim, Y., & Fitzpatrick, A. (2017). Effectiveness of patient-centered interventions on falls in the acute care setting compared to usual care. JBI Database of Systematic Reviews and Implementation Reports, 15(12), 3006–3048. https://doi.org/10.11124/jbisrir-2016-003331
Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons, and alarms. BMJ Open Quality, 6(2), e000119. https://doi.org/10.1136/bmjoq-2017-000119
Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C. (2019). Assessing the effectiveness of engaging patients and their families in the three-step fall prevention process across modalities of an evidence-based fall prevention toolkit: an implementation science study. Journal of medical internet research, 21(1), e10008. doi:10.2196/10008
Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., Ergai, A., Lindros, M. E., Lipsitz, S. R., Scanlan, M., Shaykevich, S., & Bates, D. W. (2020). Evaluation of a Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries. JAMA Network Open, 3(11), e2025889. https://doi.org/10.1001/jamanetworkopen.2020.25889
Dykes, P. C., Duckworth, M., Cunningham, S., Dubois, S., Driscoll, M., Feliciano, Z., … & Scanlan, M. (2017). Pilot testing fall TIPS (tailoring interventions for patient safety): a patient-centered fall prevention toolkit. The Joint Commission Journal on Quality and Patient Safety, 43(8), 403-413. DOI: 10.1016/j.jcjq.2017.05.002
Johnston, M., & Magnan, M. A. (2019). Using a Fall Prevention Checklist to Reduce Hospital Falls. AJN, American Journal of Nursing, 119(3), 43–49. https://doi.org/10.1097/01.naj.0000554037.76120.6a
Jong, L. D., Weselman, T., Kitchen, S., & Hill, A. (2019). Exploring hospital patient sitters’ fall prevention task readiness: A cross‐sectional survey. Journal of Evaluation in Clinical Practice, 26(1), 42–49. https://doi.org/10.1111/jep.13114
Mayhob, M. M., & Amin, M. A. (2022). Fall Prevention Interventions: Tailored Approach versus Routine Interventions among Elderly Hospitalized Patients. American Journal of Nursing Research, 10(1), 26-33. DOI:10.12691/ajnr-10-1-4
Radecki, B., Reynolds, S., & Kara, A. (2018). Inpatient fall prevention from the patient’s perspective: a qualitative study. Applied Nursing Research, 43, 114-119. https://doi.org/10.1016/j.apnr.2018.08.001
Tzeng, H. M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C. (2021). Adopting the fall Tailoring Interventions for Patient Safety (TIPS) program to engage older adults in fall prevention in a nursing home. Journal of nursing care quality, 36(4), 327-332. DOI: 10.1097/NCQ.0000000000000547
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The purpose of this assignment is to provide research evidence in support of the PICOT you developed for your selected topic.
Conduct a search for 10 peer-reviewed, translational research articles published within the last 5 years that demonstrate support for your PICOT. You may include previous research articles from assignments completed in this course. Use the “Literature Evaluation Table” provided to evaluate the articles and explain how the research supports your PICOT.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments
EBP Project was on Fall prevention in hospitalized patients in a medical-surgical unit
This is the PICOT Final Draft
PICOT Question
P Population Hospitalized adult patients in the medical-surgical ward.
I Intervention Fall Tailored Interventions for Patient Safety (TIPS) Toolkit
C Comparison Routine fall prevention protocols
O Outcome Reduced incidences of falls and injuries
T Timeframe 24 weeks.
PICOT
Among hospitalized adult patients in the medical-surgical ward (P), does the utilization of the Fall Tailored Interventions for Patient Safety (TIPS) Toolkit (I), as compared to routine fall prevention protocols (C) help reduce the incidences of falls and injuries (O) within 24 weeks (T)?Problem Statement
Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.
Falls and associated injuries among hospitalized patients are widespread in most medical and surgical wards, posing a serios threat to the safety of the patient. Accidental falls account for most reported incidences in hospitals complicating roughly 2% of hospital stays. According to Dykes et al. (2020), the rate of falls among hospitalized patients in the United States ranges from approximately 3–5 per 1000 bed-days. The incidences of falls depend on the characteristic of the unit, with patients hospitalized in the medical-surgical unit being at high risk as compared to those in the intensive care unit (Lucero et al., 2019). Consequently, studies have also reported that approximately 25% of reported falls among hospitalized patients normally result in injury, whereas 2% causes fractures. Acute care patients normally display an increased risk of falls resulting from newly altered mobility, history of previous falls, medication side effects, or altered mental status among other factors (Cuttler et al., 2017). Despite the cause, the increasing incidences of falls are becoming very costly, with increased morbidity and mortality rates from fall-associated injuries and fractures. The lack of significant fall prevention intervention despite years of struggle has contributed to the frustrations among healthcare workers, researchers, and patients at risk. It is thus time to adapt nurse-led evidence-based interventions like the TIPS tool which have proven to be effective in the reduction of fall incidences among adults in the medical-surgical ward (Tzeng et al., 2021). The facility where I work utilizes the morse fall scale (a score of 25 or higher is considered high risk), a red rose is placed on the patient’s chart as well on their door, and a red risk band is applied.
References
Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons, and alarms. BMJ Open Quality, 6(2), e000119. https://doi.org/10.1136/bmjoq-2017-000119
Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., Ergai, A., Lindros, M. E., Lipsitz, S. R., Scanlan, M., Shaykevich, S., & Bates, D. W. (2020). Evaluation of a Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries. JAMA Network Open, 3(11), e2025889. https://doi.org/10.1001/jamanetworkopen.2020.25889
Lucero, R. J., Lindberg, D. S., Fehlberg, E. A., Bjarnadottir, R. I., Li, Y., Cimiotti, J. P., … & Prosperi, M. (2019). A data-driven and practice-based approach to identify risk factors associated with hospital-acquired falls: applying manual and semi-and fully-automated methods. International journal of medical informatics, 122, 63-69. https://doi.org/10.1016/j.ijmedinf.2018.11.006
Tzeng, H.-M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C. (2021). Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home. Journal of Nursing Care Quality, Publish Ahead of Print. https://doi.org/10.1097/ncq.0000000000000547